提高外伤性脾破裂非手术治疗成功率的探讨

A protocol established to increase curative rate of non-operative management of traumatic spleen rupture

目的探讨外伤性脾破裂非手术治疗指征，以提高非手术治疗成功率。方法回顾性分析1997年1月至2000年12月以前98例（对照组）外伤性脾破裂病人临床资料，拟定非手术治疗指征。再经2001年1月至2005年6月临床收治的116例病人（研究组）应用后，与对照组非手术治疗治愈率进行对比分析。结果应用非手术治疗指征前后对比其非手术治疗治愈率分别为17．3％和33．6％，χ^2=7．28，P〈0．01，差异有显著意义。结论选择性非手术治疗外伤性脾破裂是一种安全有效的治疗手段，筛选制定的外伤性脾破裂非手术治疗指征对提高该病的非手术治疗成功率有很高的临床应用价值。

Objective To increase the curative rate of non-operative management for traumatic spleen rupture （TSR）. Methods The clinical data of 98 patients with TSR treated in our hospital from January 1997 to December 2000 were retrospectively analyzed. New indications were specified and applied to 116 patients with TSR treated in our hospital from January 2001 to June 2005. Then the outcome of the non-operative management was compared between the 2 groups of patients. Results The curative rate was significantly higher in the group of patients treated in our hospital after January 2001 than in that before 2000 （33.6% vs. 17.3%, P〈0.01）. Conclusion Non-operative management of TSR is feasible and safe in a selected group of patients. The new indication effectively increases the curative rate of TSR by non-operative management and is clinically applicable.